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目的:探讨是否完全血运重建对接受药物洗脱支架(DES)治疗的冠心病三支病变患者临床疗效的分析。评价SYNTAX评分对三支病变患者治疗策略的指导意义。方法:分析行DES植入治疗的118例三支病变患者,进行SYNTAX评分。根据是否完全血运重建分为两组。对两组患者术后3年的死亡、再次心绞痛复发、非致命性心肌梗死、非致死性脑卒中和再次血运重建事件进行随访,并综合SYNTAX评分进行分析。结果:两组间各种心脑血管不良事件(MACCE)无统计学差异,但再次心绞痛复发、再次血运重建两类事件在非完全血运重建组有增高趋势,至非完全血运重建组总体MACCE发生率高于完全血运重建组,具有统计学差异(37%vs.12%,P<0.05)。非完全血运重建组较完全血运重建组总体MACCE发生率在SYNTAX评分高计分、中低计分患者中均表现出增高趋势,且高计分患者更明显,但差异均未达到显著水平。结论:接受DES植入治疗的三支病变患者完全血运重建效果好于非完全血运重建,SYNTAX高计分患者更明显。
Objective: To investigate the clinical efficacy of complete revascularization in patients with three lesions of coronary artery disease treated with drug-eluting stent (DES). Evaluation of the SYNTAX score on the treatment of three lesions in patients with strategies guiding significance. METHODS: One hundred and eighty-eight patients with three lesions undergoing DES implantation were enrolled and SYNTAX scores were scored. According to whether the complete revascularization is divided into two groups. Three-year postoperative death, re-angina recurrence, non-fatal myocardial infarction, non-fatal stroke and revascularisation were followed up in both groups and analyzed by SYNTAX score. Results: There was no significant difference in MACCE between the two groups. However, recurrence of revascularization and revascularisation again increased in non-complete revascularization group, but not in complete revascularization group The overall incidence of MACCE was significantly higher than that of complete revascularization (37% vs. 12%, P <0.05). The overall incidence of MACCE in the less complete revascularization group than in the complete revascularization group was higher in the SYNTAX score and lower in the scoring patients than in the complete revascularization group, and the high score patients were more obvious, but the differences were not significant . CONCLUSIONS: The complete revascularization was better in patients with three lesions undergoing DES implantation than in non-complete revascularisation and was more pronounced in SYNTAX high-scoring patients.